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Health Taxes

Volume 824: debated on Wednesday 12 October 2022


Asked by

To ask His Majesty’s Government what plans they have to extend the use of health taxes in the wider fiscal system.

My Lords, given both the historically high tax burden and the cost of living pressures facing families, the Government have no current plans to extend the use of health taxes. Nevertheless, having a fit and healthy population is essential for a thriving economy and we remain committed to doing everything we can to help people live healthier lives, including by investing in sports and nutrition education to give children the very best start.

My Lords, as you would expect, I am rather disappointed with that reply, although it is not unexpected. I hope the Government are prepared to review their position on this. In 30 years, we have had 14 different strategies on health, yet we now have more obesity, more diabetes and more health problems related to overeating and overdrinking. The two factors that have had the biggest impact on behavioural change are, first, on smoking, the increase in price introduced by my party, which the Tories opposed. That was the biggest factor that changed attitudes. Secondly, I commend the Government for their work on the special levy on soft drinks introduced in 2019. There are rumours that it is to be abandoned, so will the Minister confirm that they will not abandon it? As it takes time to work these issues through, would he agree to meet with Imperial College to look at the work that has been done on taxation and how it can be brought into being without increasing the cost of living greatly?

There were a number of questions there. Tackling obesity is a major priority for this Government and we are taking up a mixture of issues. We continue to invest in supporting public health and tackling obesity. This includes a £200 million a year programme to continue the holidays, activities and food programme. To come back to the noble Lord’s points, the soft drinks levy has had an effect. Some 44% of drinks now have a reduced sugar level and that is feeding through to 36,000 individuals being less likely to become obese.

May I begin by drawing the Government’s attention to the food strategy published by President Biden about 10 days ago? It is a brilliant document which will, I hope, be enacted into law. Yesterday morning, on the “Today” show, at exactly 7.55 am, Thérèse Coffey said, in response to a question on why the Government are withdrawing restrictions on two for one offers at supermarkets because of the cost of living crisis, “We have a more positive approach to obesity than two for one”. Could the Minister explain what that is?

As I said, there are a number of initiatives to tackle obesity. Of course, I am aware of three for two or two for one offers. As we know, restrictions on these were due to come into force on 1 October 2022 and there are some extremely good reasons why they have been delayed.

Further to the question from the noble Lord, Lord Brooke, is my noble friend aware of the independent Khan review into smoking, commissioned by Sajid Javid and published in June? It recommended a polluter pays levy on tobacco companies to fund the policies necessary to enable the Government to hit their own target of a smoke-free Britain by 2030. Can my noble friend assure me that the Treasury is giving serious consideration to that recommendation?

I thank my noble friend. His question allows me to bring in an answer to a question raised by the noble Lord, Lord Brooke, as well. Over the past decade, the Government have made significant steps towards making England smoke free by 2030. We have continued to provide funding to local authorities and stop-smoking services via the public health grant. We have also provided additional resources as part of the NHS long-term plan. To answer my noble friend’s question, the Government are carefully considering the recommendation set out in the independent Khan review.

Is the Minister aware that in the decade following 2010 life expectancy in the UK stalled for the first time in 120 years? When does he expect people to be able to start living a bit longer?

It is a continuing initiative and a continuing battle to fight obesity. It is a really important issue and a cross-government initiative. I mentioned already the holiday, activities and food programme, but also bring in education, as this is also a matter of educating parents. All in all, we need to continue to do our very best to lower levels of obesity not just in adults but particularly in children.

My Lords, does the Minister agree that if the 40 million people in this country who are obese and overweight put fewer calories into their mouths, the NHS would save £27 billion? Could the Department of Health have a slogan: “Slim your waist and slim your wallet: put fewer calories into your mouth”?

My Lords, I am very aware that the latest estimate of the annual cost to the NHS in the UK of obesity-related ill health is around £6.5 billion—that is the 2021 figure. I add that physical activity and a healthy diet both have important roles to play in supporting people to improve and maintain healthy lifestyles. However, for those who are overweight or obese, eating and drinking less is one of the most important factors.

My Lords, I am grateful to the noble Baroness. The Treasury said last week that it will not be changing or reviewing the three-year public spending settlement. However, last Friday, the NHS chief finance officer said that that will result in a further £20 billion of efficiency savings as a result of the increased costs that the NHS is having to pay following inflation, and two-thirds of the new integrated commissioning services started by this Government on 1 July are already in deficit because of inflation. How will the NHS will cope with pressures on top of the existing pressures it has with the backlog of cases?

The Government are very much aware of the pressures that the NHS is facing. I think we will have to wait until 31 October for the fiscal plan to understand exactly how expenditure will work out in line with the OBR forecast and in line with how we intend to roll out our growth programme. However, I reassure the noble Baroness that the NHS is vital; there are a lot of pressures and issues to tackle.

My apologies to the noble Baroness. Following on from her question, is the problem still that the Treasury, when measuring the cost-efficiency of sensible policies such as the tax on sugar, does not offset expenditure in one department against gains made in another—in this case the Department of Health and the NHS? Can the noble Viscount tell the House whether that is still the Treasury’s practice?

I am unable to confirm that. However, I can confirm—I think this is common knowledge—that a review on efficiency is under way and, as I said to the noble Baroness, Lady Brinton, we will have to wait a couple of weeks or so to see how this will pan out.

Does my noble friend share my concern that many people in the NHS do not keep their appointments? Has the NHS considered having an appointment fee, which of course could be repayable if the appointment was kept?

I feel certain that that has been considered but I am afraid I am none the wiser as to whether it might be taken forward. Again, I will write to my noble friend if I have any update on that initiative.

My Lords, I have been listening very carefully to the Minister’s answers. I wonder whether he recalls the question from the noble Baroness, Lady Boycott. In his answer he referred to “extremely good reasons” for the delay to the implementation of the previous arrangements about buy one, get one free. Can he tell us what those extremely good reasons are? I hoped he would have done so by now.

That is a fair point from the noble Baroness. How long does she have? But if I may answer that very briefly, obviously, we are aware of the pressures that people are under, particularly those in the lower economic groups, so we felt it was right to effect a delay for a year.

My Lords, is it not a fact that the Government can send messages out to food manufacturers? They warn us of the dire consequences of increasing prices but, if they are told that there is going to be a tax, they often find ways of avoiding it and lowering the calorific content of some of these foods.

That is right. It is why the Government continue to work with industry to help deliver healthier foods and to encourage healthier eating. We want to ensure that we have a system in place to deliver healthy and affordable food for all, which also takes account of our great agricultural sector.